Introduction. Blood, Pain, and Gender: Rethinking Bleeding for a Somatechnical Age

Prelude

I woke one morning in my mid-teens engulfed by waves of puking and by the sensation that my body was being undone. Puking was unfortunately a fairly common part of the menstrual experience in my family home, as one of my sisters and I each took turns month after month hurling up our insides while reflecting on our embodiment and the unequivocal unfairness of pain. When that morning I woke up puking, my sister thought nothing of it and went to work, leaving me alone to deteriorate in convulsions and hallucinations, to enter that middle realm between consciousness and unconsciousness. That day was a ride, as my body’s attack on itself left me wandering through beautiful and terrifying landscapes unable to touch base with the reality of the situation. When my mother came home that day from her minimum wage job, it took one look at me, feverish, pale, clammy, and totally out of it on my bed, to realize that action needed to be taken fast, and she, if anyone, was a person of action. I had developed toxic shock syndrome from tampon usage, I was to learn later after some digging and prodding by doctors in the emergency room and intensive care unit, a fairly uncommon experience for menstruators who use tampons and menstrual cups. Toxic shock syndrome (TSS) is a complication associated with toxins produced by Staphylococcus aureus bacteria as well as group A streptococcus bacteria (the latter when not tampon related). Symptoms include fever, vomiting, diarrhea, rash and skin peeling, lowered blood pressure, septic shock, and organ failure. If not diagnosed quickly, one might die.

The truth is that despite the drama of my TSS experience and the trauma of being a teenage menstruating body suddenly swept into the medical realm and examined by hordes of doctors, students, and medical staff studying my body as an anomaly, my period had been trying to kill me from my earliest menstruating days. In 2002 it got me with toxic shock syndrome, and in more chronic ways throughout my menstruating life it has been accompanied by incapacitating pains linked to undiagnosed endometriosis that was dismissed by my pediatrician as “growing pains.” Not yet legal age at the time of my hospitalization for TSS, I learned of (but was denied access to by my guardian) menstrual-suppression medication, which would have minimized my risk of a repeat of TSS as well as minimized my ongoing chronic pain. Access to menstrual suppression, such as in the form of contraceptive pills containing progestin and estrogen, would have also functioned to eliminate the “wrongness” and gender dysphoria that feelings of menstruation conjured in me. I have always hated my period, as for decades it attacked my bodymind, induced weeks of cyclical pain that had left me often working in my “bed Sorbonne,” as my mother calls it (that is, my bed office), threatened me with further episodes of TSS, and made me feel like my body was under attack, taken over, fundamentally at odds with who I was and wanted to be. This book is a result of in-the-field research in and of my body, doing my best to navigate the mundane harms and realities of being a menstruating body and more recently of being a body that has elected to not menstruate, though not without side effects associated with increased estrogen intake. I use my own entangled experiences to think about the discourses surrounding pain, toxicity, gender, and menstrual suppression as a technological device both lifesaving and risky but, most importantly, as one integral to gender affirmation and pain management.

Gender, Pain, and Bleeding

Menstrual embodiment is a funny thing. Throughout Western philosophy, menstruation has too often been understood as proof of cisgender women’s inferiority and as proof of womanhood itself. Women must menstruate as part of their reproductive burden, and menstruation is sign of womanhood, the adage has gone. Menstruation has been bound to gender as material evidence of some bodies being inferior to others but also as evidence of gender itself. Menstrual suppression has thus functioned as a dangerous technology. In the over sixty years since the approval of the contraceptive pill in 1960 by the Food and Drug Administration, misogynist and transphobic fears of menstruation have circulated toward alternately supporting and decrying menstrual suppression. While most doctors have been worried about the health risks of permanently halting menstrual uterine bleeding and others have suggested that menstruation should be “obsolete” (Coutinho 1999), menstrual suppression went mainstream in 2003 with the approval of the drug Seasonale, advertised as reducing periods to four a year. Yet across these different attitudes to menstrual suppression in scientific studies and their popularizations lies a common anxiety around the role menstruation plays for gender and whether gender can be made and unmade through menstrual pharmacology in a somatechnical age—that is, an age when body and technology are inextricable from one another (Sullivan 2014). This anxiety, and the effects it has for those most reliant on menstrual suppressants—namely, chronic menstrual-pain sufferers and trans and nonbinary individuals—is at the heart of this exploration.

I hope to make two broad claims in this book concerning gender, pain, and bleeding. Both claims are invested in a vision of menstrual justice, a framing I will unpack later in this introduction. In brief, I understand menstrual justice as rooted in menstrual experiences’ intersectionality and tied to other social justice frameworks, such as reproductive justice, disability justice, gender justice, and racial justice (Ross et al. 2016). The first claim of this book, as my title suggests, is that menstruation needs to be ungendered. Until recently, feminist work on menstruation has described it primarily in relation to womanhood, since so many women menstruate at some point in their lives. Yet, while statistically this might be true, nonbinary and transmasculine people also sometimes menstruate, and countless women do not menstruate—including some trans, postmenopausal, posthysterectomy, and pregnant women, women with eating disorders, and some competitive athletes. For nonbinary and transmasculine people, periods can trigger dysphoria due to structural issues (such as a lack of access to all-gender restrooms) and as an embodied response to the incongruity of one’s menstrual blood (e.g., Chrisler et al. 2016; Lowik 2021). Yet menstruation and, all the more so, menstrual pain are “coded feminine” in ways that call upon them to be invalidated (C. E. Jones 2016, 558). I argue that one way in which menstrual pain is and has been minimized is through misogynist and transphobic discourses that bind it to femininity, or what I will discuss in the second chapter as the “womaning of menstruation.” I am interested in challenging this feminization of the menstrual experience.

Here, the term menstruator is key, as developed by critical menstruation studies scholar Chris Bobel (2010). When using menstruator rather than gendering the menstrual experience through the language of womanhood, we take steps toward menstrual justice. Language that is gender-inclusive functions to recognize that across genders people can and do menstruate. Some might argue that in using ungendered language for menstruation, we are undermining the gendered specificity of menstrually related pain, discomfort, and oppression. I disagree, because even with the usage of ungendered language we can continue to recognize that many, though not all, cisgender women do menstruate at some point in their lives. Further, menstruation’s feminization, its mythology as a fundamentally “women’s experience,” not only excludes trans women, trans men, and genderqueer people from menstrual justice but has actually been used against cisgender women as part of a Western rubric of justifying women’s oppression through blood. Menstruator language is thus a key rhetorical move in transforming our understanding of menstruation by disengaging from a sexist and transphobic attachment to both cisgenderness and womanhood. It is also an attempt to provide “gender-affirming solutions to meeting the menstrual health needs of trans and non-binary people,” which necessitate that we “deviate from medicalised and social constructions of menstruation as a symbol of womanhood” (Lane et al. 2022, 1409). Additionally, using the language of women instead of menstruators erases the experiences of children who menstruate, rhetorically thrusting them into adulthood. This last point was made clear to me by an X (formerly Twitter) post by @fitnfuII, who reposted a post by @misandresthet from January 20, 2024, whose account has since been taken down for posting pro-Palestinian content. As @fitnfuII wrote in response to Palestinian menstruators in Gaza being barred from access to menstrual gear by Israel, “Young girls who menstruate are not women. They are Children.” Using menstruator-informed language thus also refuses to label children who have experienced menarche as “women,” acknowledging the biologically essentialist violence of this denial of childhood and how it functions rhetorically to erase the childhood of people in occupied and colonized or formerly colonized nations in particular.

Ungendering—as my title suggests—is central to this project, though I want to be clear that the work of ungendering is not in and of itself necessarily liberatory. Hortense J. Spillers’s (1987) transformative work demonstrates that, because gender has been used in service of white supremacy to purport that Western and white ethnic groups are superior in their sexual dimorphism, ungendering has been utilized to deny the humanity, personhood, and individuality of Black people. The project of enslavement and its legacies, Spillers outlines, rely on the ungendering of Black people, of rendering bodies fungible through depersonifying them and ridding them of gendered markers and social roles (Snorton 2017). Coercive ungendering by white supremacy thus functions in direct contradiction to projects of liberatory ungendering that seek to increase, rather than diminish, possibilities not only for gender but also for various highly specific ways in which bodies can be experienced. Ungendering in this sense questions the naturalization of certain phenomena as the property of gender, including the idea that menstruation is the property of only one gender. “Gender,” here is what Marquis Bey describes as “that which is made to attach to bodies of a domesticized space, predicated on the integrity of an ontology constituted by a white symbolic order” (2019, 56). Ungendering, in response, presents a challenge to this naturalized ontology of gender, including the links that have been drawn between menstruation and womanhood. Additionally, ungendering is at the heart of this project because I hold that it is menstruation’s gendering that allows for it to function to uphold narrow ideas around binary gender embodiments and that it is through gendering that menstrual pain and trauma are made acceptable, permissible, routine.

This relates to my second claim, which is to argue against an approach to menstrual management that is grounded in ideas of pain minimization and one-sided celebrations of the menstrual event. I have noticed a discursive shift in Western countries in the last decade toward celebrating menstrual cycles and challenging sustained menstrual negativity that renders menstruation disgusting and in need of containment. Incredible pro-bleeding projects have been undertaken by artists, communities, scholars, and activists who strive to shift disparaging cultural messages around bleeding that have for too long denigrated menstruators through shame, so-called hygiene politics, and menstrual negativity more broadly. While I agree with the value of this approach, I also believe that menstrual politics need to leave space open for acknowledging the troubling and difficult aspects of bleeding, such as chronic pain, gender dysphoria, and discomfort. Menstrual pain (dysmenorrhea) as well as endometrial pain have been denied the status of real pain until recently, even while upward of 80 percent of menstruators experience pain related to bleeding and nearly 30 percent experience “severe” pain (Ju, Jones, and Mishra 2014; Grandi et al. 2012). Pain associated with menstruation is routinely dismissed as a “woman’s problem” or as “psychosomatic” or “psychologized”—invented or imposed by the mind onto the body rather than fundamentally somatic (even if also experienced by the mind). Only recently has some attention been paid to menstrual pain as comparable to the pain of a heart attack (Fenton 2016), resonating with questions crip theorist Alyson Patsavas raises around “Who gets to feel pain? And what kinds of pain are they ‘allowed’ to feel?” (2014, 204). In this sense, my project centers the importance of thinking with pain and of developing “cranky” and dissident approaches to aspects of menstrual embodiment that are painful and dysphoric. I claim the value of acknowledging menstrual embodied complexity and refusing one-sided co-optations of menstrual positivity as part of the rebranding of the menstrual experience. Emilia Sanabria, in her ethnographic work on menstrual suppression in Brazil, recognizes that “menstruation can be at once eagerly anticipated and detested, painful and yet welcome, or considered mucky and nevertheless cleansing” (2016, 43). Hating one’s period is very much part of the menstrual experience, this is true, but I push back against the normalization of menstrual pain as something that is simply and purely part of being menstrually embodied. The lived messy embodied realities of menstruation, especially for pain sufferers and those who experience periods as dysphoric, means that we need to recognize that menstrual bleeding can take the form of corporeal hell. In what follows of this introduction, I map out some initial thoughts as to what a menstrual justice framework might look like, proceeding to lay out the chapters of the book.

Toward Menstrual Justice

Legal scholar Margaret E. Johnson discusses menstrual injustice as “the oppression of menstruators, women, girls, transgender men and boys, and nonbinary persons, simply because they menstruate” and as including health and economic disadvantages (2019, 1–2). Menstrual justice, like other justice-based frameworks, is grounded in an understanding that rights-based frameworks that rely on institutions such as governments to grant specific capacities are insufficient. In this sense, menstrual justice recognizes that menstrual experiences must be engaged with intersectionally, acknowledged to be connected to other social justice frameworks including racial justice, reproductive justice, gender justice, trans justice, and disability justice (Ross et al. 2016). In the context of the rise of right-wing populist governments around the world, including in the United States, where inalienable rights around bodily autonomy for people with uteruses, women, and trans people are being increasingly clawed back, justice frameworks become especially important. Reproductive justice initially emerged in the United States to respond to a reproductive rights agenda that advocated for the inalienable right to abortion and contraception but failed to recognize the sterilization and coercive use of birth control against Indigenous, Black, Puerto Rican, and other people of color (Torpy 2000; D. E. Roberts 1997). The birth control pill itself was developed through coercive and nonconsensual testing on the bodies of Puerto Rican cisgender women such that between 1930 and 1960 an estimated one-third were sterilized (Nelson 2003; Lopez 2008). Coalitional groups such as the Puerto Rican–led Young Lords Party sought to argue for a reproductive justice framework to shed light on and bring an end to this unjust sterilization, while demonstrating that reproductive rights frameworks often served white women. Some Black feminists in the 1970s even framed the birth control pill as a colonial tool because of its racist history of development and coercive use on Black, Indigenous, and other people of color (BIPOC) (Bambara 1970).

In the face of the racist basis of the reproductive rights agendas, reproductive justice was invested in both the freedom “to” and “from”—that is, in bodily autonomy for all, including the possibility of reproducing and of choosing to opt out of reproducing (Fahs 2014). Further, reproductive justice also recognizes that the right to have or forgo having a child is not sufficient but must also include crucial third and fourth principles: the right to bear children in safe and nontoxic environments and the right to affirm gender and sexual autonomy, including bodily autonomy for trans people (Ross and Solinger 2017). Fundamentally, then, reproductive justice recognizes that we must go beyond neoliberal conceptualizations of choice that imagine atomistic individuals severed from communities and move to a more robust model of contextually based access. In this sense, to be able to parent, select when to parent, or forgo parenting, requires access to abortion, food, nontoxic environments, an end to occupation and genocide, technologies and knowledges around pregnancy for all genders, “contraception, comprehensive sex education, STI prevention and care, alternative birth options, adequate prenatal and pregnancy care, domestic violence assistance, adequate wages to support our families, safe homes, and so much more” (Sister Song, n.d.).

Menstrual justice is embedded in and distinct from reproductive justice. On the one hand, menstrual justice is integral to robust reproductive justice because menstruation is tied to both reproduction and bodily autonomy. On the other hand, it is vital to emphasize menstrual justice as distinct from reproductive justice because it demands specific modes of access that are lost and subsumed if menstruation is bound only to and in service of reproduction. For example, as someone who has never wanted to have children, I have never configured my menstruation as tied to potential reproductive capacities. Instead, because for me menstruation was tied to chronic pain as well as gender dysphoria, it makes more sense for me to see menstrual justice as both distinct from and as tied to disability justice and trans justice. Menstrual justice thus needs to be understood dynamically and as distinct from reproductive justice, which it is usually consumed under, if thought of at all.

Swatija Manorama and Radhika Desai, looking at menstruation in India, suggest initial thoughts around what menstrual justice might consist of. They mention that for menstrual justice to be attained, state-level and institutional change needs to happen in ways that offer “an alternative understanding of women’s biology and health” (2020, 512). In this sense, menstrual justice needs to take menstruators’ racial, religious, and class backgrounds into account as well as their geopolitical location, such that “the central tenet of the menstrual justice approach is that menstruation is a physiological process directly linked to psychosocial and cultural–religious aspects” (512). Since menstruation is both cultural and of the body, menstrual justice needs to acknowledge both the materiality of bleeding and the cultural and discursive contexts in which it takes place. A justice approach to menstruation, as Manorama and Desai discuss, must unravel notions of individual choice tied to bleeding as they are packaged in Western contexts. In such contexts, such as the United States, menstruation has been presented through the prism of neoliberal choice and agency such that menstruators purportedly choose which period products they use (such as tampons, pads, and cups—though in reality, due to economic and other reasons, this is not much of a choice at all) and how often they might menstruate (including through the popularization of extended-cycle oral contraception such as Seasonale, which advocates for four periods a year). The supposed choice of whether to menstruate is less frequently extended as part of this neoliberal bleeding package, nor is acknowledgment of the costs of and access to menstrual gear, including for people experiencing houselessness and those in prisons and detention sites. Menstrual justice, in short, drawing on Manorama and Desai, must include state-led and structural change and direct “attention to the role of the political institutions and state policies” to make menstruation more bearable (512). A justice framework recognizes the role institutions play in the conditions of our lives, including in the conditions of menstruating lives.

Yet Manorama and Desai’s articulation of menstrual justice continues to tie bleeding to womanhood, reproduction, and fertility, to “women’s experiences of indignity, discrimination, inequality, and injustice,” skirting a vision of justice that questions the menstrual sanctification of womanhood and acknowledges the central role that pain and disability play for many menstruators the world over (512). Menstrual justice in this sense has a lot to learn from disability movements and visions for disability justice, which reorient us to center support, care, community, bodies, and availability of technologies in pursuit of leading full lives (Piepzna-Samarasinha 2018). Patty Berne, founder of Sins Invalid, a disability art troupe, suggests a series of ten core principles for disability justice that include leadership by the most affected, intersectionality, interdependence, collective access, cross-disability solidarity, and liberation (Berne 2015). In The Palgrave Handbook of Critical Menstruation Studies, which features Manorama and Desai’s chapter, I and my coauthor Breanne Fahs write that “menstrual justice . . . includes thinking about menstruation, menstrual pain, and access to menstrual products intersectionally, and in dialogue with one’s position in relation to power structures. Menstrual justice also includes seeing access to menstrual products, including pain control, as a human right as well as understanding menstrual pain as a form of chronic pain that necessitates proper access to care” (2020, 376). Attending to pain and the complex systems of mutual support needed to navigate pain is thus part of the vision of menstrual justice. What would it look like if menstrual pain and other pain connected to menstruation such as endometriosis were not minimized or elided by medical professionals, family, and friends, including other menstruators? What would it feel like if crip temporalities that acknowledged the realness of menstruation-related pain were upheld as part of daily, weekly, and monthly work schedules? How would menstruation become more bearable for chronic pain sufferers if attention was paid to pain management technologies aimed at menstruators and robust access to menstrual suppressants? These are all questions that a menstrual justice approach attuned to pain and embodiment seeks to bring forth in dialogue with disability justice.

Similarly, trans justice informs menstrual justice and is interconnected with reproductive and disability justice. Trans justice supports and validates bodily autonomy through asserting access to gender-affirmative surgeries and practices. Trans justice also strives to offer community protection from transphobia by advocating for incarcerated trans people, sex workers who are trans, migrant trans people, and freedom from transphobic discrimination at its intersection with racism, poverty, ableism, and citizenship status (Trans Justice Funding Project, n.d.; Spade 2015). Because trans people disproportionately experience discrimination and inequities, including those tied to medical and health care, and because trans people routinely face institutional injustice from rights-granting bodies, the police, and medical institutions, “queer and transgender activists have for some time emphasized the importance of seeking justice through intersectional resistance that prioritizes multi-axis analysis, such as disrupting institutional systems that perpetuate racialized-gendered violence” (Wesp et al. 2019, 288). Trans justice is fundamentally part of a robust vision of both reproductive justice and disability justice since trans people also parent and choose not to parent and may have disabilities. For example, grassroots groups such as the Mountain Area Abortion Doula Collective (n.d.) in Asheville recognize the importance of centering trans justice in reproductive justice, understanding bodily autonomy to include access to abortion as well as access to gender-affirmative medicine. Similarly, menstrual justice must dialogue with trans justice through a recognition that trans and nonbinary people do menstruate, that menstrual pain also affects trans and nonbinary menstruators, and that menstruation and inequities surrounding menstruation, from social stigma to lack of access to both menstrual products and suppressants, are a concern for all. A vision of menstrual justice thus must include an understanding of menstruation and its experiences as not bound to or corralled by gender.

Before outlining a series of menstrual justice principles, I want to provide a look into two grassroots organizations that are already living this vision. The first of these, created in 2015, is #HappyPeriod, a Black-led organization centered on menstrual health education, advocacy, and access. While their name might suggest an investment in neoliberal notions of period positivity of the sort I will unpack in the first chapter, the group actually rethinks happiness from a justice perspective by centering menstrual care and focusing on offering care to BIPOC menstruators in particular. The group’s website discusses how they formed in response to seeing a houseless woman free-bleeding and were subsequently motivated to think about access to menstrual products for low-income bleeders. Care figures centrally in justice-based perspectives, including in disability and trans justice, as care networks can be central to supporting trans and disabled people in the face of institutional neglect and malpractice (Malatino 2020, 41; Piepzna-Samarasinha 2018). #HappyPeriod also envisions justice through refraining from specifying a single gender of menstruation, envisioning their “work to empower and serve the quality of life of Black, Latinx, and/or Indigenous identifying women, girls, femmes, and gender expansive humans” (#HappyPeriod, n.d.). The group’s vision suggests the possibility for a gender-affirmative menstruating project grounded in principles of justice and care.

Similarly, Code Red Collective is a period literacy and advocacy organization that promotes menstrual wellness and period destigmatization. Like #HappyPeriod, Code Red Collective is a Black-led “co-powering cooperative organization” that articulates a vision of collective care and utilizes menstruator-forward language (Code Red Collective, n.d.; Jaiyeoba 2020). Their projects focus on providing access to menstrual products across intersections of bleeding and period poverty, racism, incarceration, and transphobia, with the goal of increasing access to period products, literacy, and advocacy. Through an intersectional approach to bleeding, the collective is envisioning menstrual justice across menstrual experiences while also challenging institutional injustice. Both Code Red Collective and #HappyPeriod articulate menstrual justice as grounded in a response to institutional inaction through principles of access, care, and gender affirmation. Yet, notably, neither group sufficiently considers the overwhelmingly central role pain and pain management and, concomitantly, menstrual suppression can play for bleeders across genders.

Drawing on the above discussion of reproductive, disability, and trans justice, alongside grassroots organizations crafting a praxis of menstrual justice, I have developed the following principles of menstrual justice. While recognizing that justice is not ever a complete set of principles that can be enumerated, these guiding principles direct menstruators and allies to recognizing menstruation as complex, multiple, and at the intersection of experiences of injustice and thus grounded in principles of access and coalition. Rather than comprehensive, this list gestures to the capaciousness of menstrual justice. Because justice frameworks are not abstract lists and lose their acuity when removed from the practice of daily life, this list necessarily needs to be adapted based on geopolitical context in conversation with the injustices experienced in particular sites and by particular communities in relation to institutional power. The work of ungendering menstruation is at the heart of menstrual justice because it confirms access for all and especially for those most marginalized.

Menstrual justice, as I see it, includes:

1. A recognition of the structural issues facing menstruators and their geopolitical specificity with “attention to the role of . . . political institutions and state policies” in the discourses and lived realities menstruators experience (Manorama and Desai 2020, 512)
2. An attunement to an intersectional framework that acknowledges the complexity and plurality of menstrual experiences across age, gender, race, religion, ability, and sexuality and how these affect the material realities of menstruating (Johnson 2019)
3. An understanding that experiences of menstruation are complex, neither unilaterally positive nor negative, and that they can be a source of meaning and joy for some and a source of dysphoria, pain, and trauma for others
4. Freedom “to” and “from” menstruation for all menstruators (Fahs 2014)
5. Liberation from occupation, colonization, and war, all of which necessarily worsen menstruators’ access to menstrual products, including pain management, and undermine principles of freedom for menstruators
6. Access to environments that are low in toxicity and pollution and to products that are free from dangerous chemicals and that do not accumulate in the environment
7. An investment in access to menstrual suppressants, menstrual pain management, menstrual products, and comprehensive menstrual education divorced from reductive messages around gender and reproduction available to both menstruators and nonmenstruators across age groups; access to menstruation support should be understood not as elective but as essential, life- and gender-affirming
8. A trans-affirmative commitment to medical care that is grounded in the knowledge that menstruation is not the property of any one gender but that it occurs for some people who have uteri, and an accompanying refusal to bind menstruation to womanhood and reproduction or to essentialist understandings of gender or bodies
9. Medical training that includes both gender-affirmative and ungendering menstruation language and recognizes the realness of menstrual pain and a commitment to helping menstruators manage, decrease, and eliminate menstruation-related pain
10. Community-based care that is invested in supporting menstrual-pain sufferers and menstruators more broadly, including through a recognition that menstrual pain, as pain, demands rest, time off from work, and other cyclical accommodations
11. A broad shift in social and cultural understandings around both menstruation and what classifies as “real pain” to allow for accommodations of those menstruators who are in or live with chronic pain

I begin this book with an articulation of menstrual justice because it will provide a guiding point for the chapters that follow. Menstrual justice is an important starting point because it frames ungendering menstruation, access to menstrual suppressants, and the recognition of the realness of menstrual pain as part of a broader fabric that must also include attention to period poverty, uneven access to menstrual products and technologies, and the sexist and transphobic dynamics of menstrual negativity. Further, access to menstrual suppressants that can help navigate pain and affirm gender needs to be seen as life-affirming rather than elective, as part of a broader net of menstrual justice. Toward grappling with the gendering of menstruation and the denial of menstrual pain, this book unfolds through several chapters that are informed by many dynamic fields, including critical menstruation studies, disability and crip studies, and trans and queer studies.

Chapter Composition

My first chapter, “Miserable Menstruators: Toward a Cranky Approach to Bleeding,” will argue for honing a “cranky” approach to menstrual bleeding that makes space for acknowledging the ways in which menstrual bleeding can be experienced as difficult both structurally and in the body, including through menstruation-related chronic pain and dysphoria. Feminist discourses are often co-opted and repackaged back to us by advertising and mainstream culture. Such is the case with recent rebrandings of menstruation, especially by menstrual product advertising, which calls on us to unequivocally “love” our periods when only a decade or so ago the same menstrual product companies were hailing menstruators into discourses of secrecy, shame, and blue liquids. In other words, expertly sculpted and dynamic feminist theories and embodiments of body positivity and menstrual positivity that have adroitly responded to a culture of body shame and menstrual negativity have been rebranded and thinned, calling on bleeders to love their periods at all and any costs and acontextually, without attention to period injustice, period poverty, and period trauma. A cranky approach to bleeding that sits with the possibly difficult, painful, and unjust elements of bleeding, this chapter argues, is necessary to challenge the affective prescription of period joy.

Following this, “Suppressing Histories: On the Womaning of Bleeding” is interested in thinking about gender and menstruation and about how menstrual-suppression technologies could succeed in ungendering menstruation, though they haven’t yet. This chapter puts forward a theory for the ways in which menstruation undergoes what I call a “womaning”—or the collapse and fusing of menstruation with cisgender womanhood. I argue that this takes places in three ways: through an attachment to woman-centric language that makes bleeding the terrain of cisgender women, through a prescriptive understanding that menstruation is part and parcel of womanhood, and through the sense that bleeding is the duty of women. I argue that while certainly transphobic in its anxious protection of cisgender womanhood through bleeding, this womaning is also misogynist and harmful even to cisgender women who are assigned the material status of being menstruating bodies as the price of being women. Next, I focus on two cases connected to menstrual suppression and how they uphold the womaning of bleeding. The first being Brazilian gynecologist Elsimar Coutinho’s investment in making menstruation “obsolete.” Drawing on anthropologist Emilia Sanabria, menstruation has indeed become more elective in Brazil than it is in the United States because of Coutinho’s work. However, Coutinho’s obsoletion thesis is based on a denigration of menstruation as pathological, further fueling a climate of menstrual negativity. Second, I look at the U.S. appearance of Seasonale in 2003, a drug advertised as reducing periods to four a year. Yet, as with Coutinho’s thesis, Seasonale has not effectively ungendered menstruation so much as rendered it a less central inconvenience for menstruating women, to whom it is advertised. If these two cases of menstrual suppression have not led to a robust ungendering of menstruation, what would it take for menstruation to be severed from notions of womanhood and what role can elective bleeding play? Why are we so socially invested in the notion that women bleed and must bleed, tying menstruation to gender and its suppression to anxiety around gender?

And finally, my third chapter, “Toxicity, Environmental Leak: On Pain and Menstrual Trauma,” returns to thinking about pain in relation to menstruation by way of thinking about menstrual trauma. Period trauma is a term I only recently encountered, coined by Charis Chambers, a Black ob-gyn and social media influencer known as “the Period Doctor.” Menstrual trauma landed on me hard as a perfect term to describe the many forms of “sustained psychological, social, or emotional injury/distress related to or caused by menstruation” (Bunch 2021). Even with the privilege of having access to menstrual products, so much of my life has been governed by period trauma: toxic shock syndrome related to tampon usage, chronic menstrual pain, undiagnosed endometriosis, dysphoria, and the side effects of menstrual suppression. If I were not a menstruator, none of these would have characterized the life of my body. While I have looked at the chronicity of menstrual pain as a crip form of embodiment in a previous publication with Breanne Fahs (2018), in this chapter I want to turn to the trauma of being a toxic shock syndrome survivor. I look at menstrual product toxicity as it relates to TSS and environmental pollution and explore how some forms of toxicity and trauma are rendered permissible while others are not. Together, these chapters make a case for both the ungendering of menstruation and the need for hailing a cranky arsenal to refuse the further erasure, dismissal, and denial of menstrual pain as real pain. This book argues that menstrual bleeding should be a choice afforded to every menstruator, understanding the structural limits that make menstrual choice impossible for many, including those without access to health care, those in occupied territories and low-income countries, those from conservative backgrounds, and those faced with medical transphobia. If menstruating is framed as somatechnically elective, I hold, it provides avenues for celebrating and appreciating cultures of bleeding as well as for remaining critical of the ways in which bleeding has been used as a transphobic and sexist tool to gel gender in place.